When poor cocaine or heroin addicts in Chicago want to kick their habits, one of the first places they are likely to call is the Chicago Addiction Treatment Center, or CATC -- a free, city-owned clinic located in a converted hospital just down the block from the Cook County jail.

But most days, there is little help to be found. Every one of the program's 70 beds has been full for months. Callers seeking help are asked to check back in a few days. It can take six weeks or longer to get in.

For some antidrug professionals, such delays illustrate the need for more treatment programs to care for the swelling numbers of inner-city drug abusers. But there is another aspect of the CATC program that gives even treatment advocates pause: About 80 percent of those who do enter the 28-day program are back using drugs and alcohol within a year, according to figures provided by program officials.

As the Bush administration and Congress prepare to sharply increase funding for drug treatment, the relapse rates at most programs -- every bit as high as the recidivism rates at the worst prisons -- explain why there is still widespread skepticism about the effectiveness of treatment as a solution to the nation's drug problems.

It also explains why many federal officials believe more needs to be done to develop drugs and methods that can treat cocaine abusers.

"When people say treatment works, it's true, but it's a limited statement," said Frederick K. Goodwin, administrator of the Alcohol, Drug Abuse and Mental Health Administration.

"It works for the middle and upper class that have a lot to lose," he said.

"But for the major group of drug abusers, for the crack epidemic, in the inner cities, we don't have nearly enough knowledge about what works and how to stop the craving for the drug," Goodwin added. "The area where the biggest problem is is the area where we know the least."

This cautionary note is reflected -- in muted form -- in a recent 35-page "white paper" on treatment released by William J. Bennett, national drug control policy director. The paper was hailed by some Democrats and treatment advocates because it unequivocally embraced treatment as a "crucial" part of the administration's antidrug strategy. It also pointed out that this view is being backed up with money: The president's budget request calls for spending $1.46 billion on drug abuse treatment next year -- a nearly 70 percent increase from just two years ago, and an amount Democrats want to raise to over $2 billion.

But at the same time, the white paper -- drafted by Bennett deputy Herbert D. Kleber, a Yale Medical School psychiatrist and specialist on drug abuse -- concludes that "no one, certainly not treatment professionals, can be satisfied with our current rates of success."

In broad outlines, that conclusion holds true across the board, regardless of the type of treatment program. Even at expensive private rehabilitation centers, which can cost anywhere from $5,000 to $15,000 for a standard one-month stay, about two-thirds of cocaine abusers will either drop out or return to drug use within one year, according to a series of surveys conducted by Norm Hoffman, executive director of CATOR, a research company that evaluates success rates of private treatment programs.

At publicly funded programs in the inner cities, the outcomes can look even worse. At the Veterans Hospital in Philadelphia, about 120 drug abusers enter the emergency room with drug-related episodes every month and get referred to the hospital's outpatient drug treatment clinic, according to Marian Droba, director of the clinic and psychiatrist at the University of Pennsylvania's Addiction Research Center.

But only about 60 ever show up and usually no more than 20 will make it through the first month, Droba estimates.

Nor does it seem to make much difference whether patients go to high-cost, residential programs or much cheaper outpatient clinics where they attend counseling sessions several times a week. One study performed by the University of Pennsylvania center found sobriety was slightly higher among patients at outpatient clinics -- a conclusion that contradicts long-standing assumptions that drug users must be temporarily "removed" from their environment to free themselves from drugs.

The relative ineffectiveness of short-term clinics has lead some professionals to promote the advantages of so-called "therapeutic communities" -- physically and mentally demanding boot camp-like programs. These programs can last from between one and two years and are aimed at reordering an individual's personality and teaching job skills. "We're not simply addressing whether a person has a craving for a particular drug. . . . We see drug abuse as a symptom of a totally disordered personality, with a variety of underlying social problems," said Mitch Rosenthal, director of Phoenix House, the New York-based therapeutic community. "We're treating the whole person. . . . In 25 years, I have not seen any other methodology that seems to hold any promise."

Like many therapeutic communities, Phoenix House claims higher success rates than most treatment clinics: In one study of 100 Phoenix House graduates, 93 percent who completed a two-year program were "totally drug free," and employed seven years later, Rosenthal said.

But, as always, there is a caveat: As many as 85 percent of the drug abusers who enter Phoenix House drop out before the program is over. "It's hard to tell a drug addict to get up at six in the morning and start living like a responsible person," said Steve Dnistrian, a Phoenix House spokesman.

That is what many professionals concede is the underlying problem with expanding treatment programs: Most drug abusers, including most of those who sign up for treatment programs, are simply not serious about wanting to stop using drugs. Increasingly, drug abusers are being "coerced" into treatment, either by the courts, employers or their families. Many are not convinced they have a problem and end up benefiting little.

"Nobody could have helped me," said Stanley Warren, a 40-year-old former postal worker and crack addict who has been through six drug treatment programs in the last four years and now is drug-free. "I don't believe I ever really had a strong desire to stop. I always figured I still had a few more moves left. . . . Once I got out {of a treatment program}, I don't think I lasted more than two weeks."

Many treatment professionals say that is no reason to fail to extend help to addicts in need. Success rates of 40 percent or less may not "look great . . . but it's better than you get with lung cancer," argued Hoffman. Moreover, many treatment patients such as Warren may have to go through programs repeatedly before they take hold. "This is a chronic illness, and it requires a long-term perspective," said Hoffman.